PET-CT Scan Machine
DEPARTMENT OF NUCLEAR MEDICINE
Head of Department:
Dr. Ankit Kumar MBBS, DRM ( Nuclear medicine & PET-CT)
What is nuclear medicine?
Nuclear Medicine is a non-invasive medical speciality. the process involves injecting a small number of radio-pharmaceuticals into patients, some specific radio-pharmaceuticals may also be given by oral and inhalational routes to assess medical conditions for diagnostic molecular imaging and therapeutics. These medical conditions include cancer, heart disease, gastrointestinal, endocrine, or neurological disorders, and other conditions. Nuclear medicine exams pinpoint molecular activity. This gives them the potential to find disease in its earliest stages. They can also show whether you are responding to treatment or not. With the addition of new technologies like hybrid imaging combined with nuclear medicine and other advanced techniques like PET/CT PET/MRI, the field of nuclear medicine has grown by leaps and bounds.
What is PET-CT??..
Positron emission tomography :
Positron emission tomography, also called PET imaging or a PET scan, is a type of nuclear medicine imaging. It is a functional imaging technique used to observe metabolic processes in the human body. Current PET equipment is an integrated PET-CT machine that allows the acquisition of both PET and CT on one platform. PET provides the essential signals of the tumour, and CT helps in localisation.
Upon requiring a regional contrast-enhanced CT (CECT) scan, can also be performed with the same equipment in the same sitting. Which helps us in early diagnosis, response assessment, restaging, and follow-up of cancer patients. Nowadays it is also very useful for radiation oncologists in radiotherapy planning. Many a time, we used to do PET-based tumour biopsy and reduce the multiple procedures. PET may also detect complex systemic diseases such as coronary artery disease, memory disorders, and seizures. PET has diagnostic value in the fever of unknown origin when all other investigations are exhausted.
NOTE- Just like a few other procedures, this scan also requires a patient to be prepared in advance as per the doctor’s instructions.
PRINCIPLES OF PET-CT SCAN
- Is an imaging technique that uses a small amount of radiolabeled biologically active compound to help in the diagnosis of disease.
- The tracer is introduced into the body by intravenous injection.
- PET scanner is used to produce an image showing the distribution of the tracer in the body.
Why we need PET-CT?
PET-CT helps us in the staging of cancerous disease, response assessment, restaging, and follow-up of cancer patients. PET-CT scan is useful in early diagnosis in case of unknown primary malignancy. Many a time, we used to do PET-based tumour biopsy and reduce the multiple procedures. PET may also detect complex systemic diseases such as coronary artery disease, memory disorders, and seizures. PET has diagnostic value in a fever of unknown origin when all other investigations are exhausted. Nowadays PET-CT is also very useful for radiation oncologists in radiotherapy planning.
PET-CT indications in oncology
- Staging of cancer.
- For early evaluation of treatment response (differentiate between responder & non-responder).
- Response assessment (effectiveness of treatment).
- Follow-up of cancer patients.
- Detection of recurrence.
- Early diagnosis in case of unknown primary.
- Radiation therapy planning.
- Identifying the correct site of tumour biopsy (pet-guided biopsy).
Non oncological INDICATION of PET-CT
- FDG-PET/CT in Evaluation of Infection & Inflammation
- Fever of unknown origin
- Granulomatous disease ( tuberculosis, vasculitis, sarcoidosis, arteritis etc.)
- Infected prosthesis implants
- Neurological applications :
- Alzheimer & other dementia
- Seizures and epileptic disorder
- Parkinsonism (18F- DOPA PET)
- Cardiac and Vascular application
- Cardiac viability assessment (is the patient a bypass candidate?)
- Determine which patients will benefit from cardiac transplantation
- Cardiac sarcoidosis when MRI is contraindicated
- Cardiac infection and inflammation (prosthetic valve infection etc.)
PET-CT IN ROHILKHAND CANCER INSTITUTE
- PET-CT DISCOVERY IQ 3 Ring scanner 2nd Generation with Q-Clear technology, the most advanced system
- With this novel, cutting-edge technology, we provide a new horizon to our patients.
Various PET Radiopharmaceuticals are available at RCI.
18F-NaF PET ( for Bone metastasis)
18F- PSMA PET ( for Prostate cancer)
18F-DOPA PET ( for Parkinson’s disease)
Preparation for PET-CT Scan
- Doctor’s prescription.
- Any previous scans and reports (CT, MRI, PET-CT). Comparison with the previous scan provides better disease assessment as progression or regression.
- Advise not to eat anything at least 6 hours before the scheduled appointment time.
- Preferably low carbohydrate diet should be taken 24-48 hours prior to the study.
- Blood sugar should be within the normal range on the day of the test.
- Bring the latest (not more than one month old) KFT report (Blood Urea and serum Creatinine) which is required for contrast studies.
- Should NOT take insulin injections or take diabetes medicines in the morning. Can take rest of the medications
- Can drink water though
During the PET Scan
- Clinical history will be taken by the doctor/nursing staff.
- Patient may be asked to change into a loose-fitted gown, which is provided by Rohilkhand Cancer Institute.
- Remove any/all metal objects, such as a belt or jewellery before the scan, as these might interfere with imaging.
- After checking the Nuclear Medicine Specialist along with the Physicist/ Technologist will inject the radiopharmaceutical (F-18 FDG).
- Patient will be taken to a ‘post-injection room’, the Patient will have to drink water, and remain calm, quiet and in isolation during this period.
- Patient may be asked to drink the oral contrast which is required for the CT in PET scanning.
- Before imaging/scanning, the patient will be asked to urinate in order to empty his/her bladder.
- Patient will be asked to lie in the supine position on the table under the PET-CT machine.
- The PET scans trace the distribution of F-18 FDG throughout the body. These scans take about 30 minutes and the patient will need to lie still for that time.
- Sometimes patients may be asked to come again for delayed images.
After the PET Scan
- Ensure that the I.V. line is taken out once the test is completed.
- After the test is complete, the patient can leave the hospital unless some other instruction is provided by the doctor.
- The patient should drink plenty of water to give a passage to tracers out of the body. Generally, after a few days, the tracers are completely diluted out of the body.
- A ‘report collection slip’ will be handed over to you by the Technical Staff/Staff nurse at the completion of the test. Patients/ attendant can collect their reports from the Rohilkhand Cancer Institute report collecting desk at the stipulated date & time.
PET-CT machine we have
Discovery IQ Gen 2 PET-CT with 3 rings & Q.Clear technology. (The next generation PET-CT)
Rohilkhand Cancer Institute uses Discovery™ IQ 2nd Generation PET-CT is the most trusted PET-CT system. It has been designed and engineered to be a scalable, high-performance diagnostic system with the capabilities to produce exceptional image quality.
Discovery IQ Gen 2 is the next generation of high-performance PET-CT systems thoughtfully engineered with faster scan times, lower dose techniques, and the ability to scan patients of all sizes. combining best-in-class sensitivity with motion-free image clarity and trusted Q.Clear quantitation.
Q.Clear has delivered fast and efficient quantitation readings for confident diagnosis and precise treatment response assessment by providing up to two times improvement in both PET quantitation accuracy (SUVmean) and image quality (SNR).